Diagnostic Role of Bronchoscopy guided Endobronchial Needle Aspiration cytology Exophytic endobronchial lesions: A single-center study in a tertiary care setting in India

Diagnostic Role of Bronchoscopy guided Endobronchial Needle Aspiration cytology

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  • Shital Patil
  • Abhijit Acharya
  • Sachin Babhalsure




Objective: In present study, various conventional diagnostic techniques (CDTs) such as endobronchial forcep biopsy (FB), bronchial washing (BW) and endobronchial needle aspiration cytology (EBNA) are employed during fiber-optic bronchoscopy for diagnosis of exophytic endobronchial lesions (EEL) and special emphasis is given to EBNA.
Material and method: Prospective, observational study, screened 1280 cases with suspected lung malignancy on clinical and radiological basis. Bronchoscopy guided techniques such as EBNA, BW, FB is used in exophytic endobronchial lesions (EEL) in confirming the diagnosis of lung cancer and to find additive yield over other techniques such as BW and FB. Rapid on-site evaluation (ROSE) analysis of all EBNA samples done in pathology lab allied center. Finally, histopathology proven 810 lung malignancy cases are included in study. Statistical analysis is done by using chi-test.
Results: In present study, 810 diagnosed lung cancer patients between 29-85 age group predominant males 59.25% (480/810) and smokers by addiction in 63.20% (512/810) cases. Presented with cough in 82.09% (665/810), clubbing in 56.17% (455/810) cases & mass lesion in chest radiograph in 42.22% (342/810) cases. Anatomical location is documented on right side of tracheobronchial in 59.01% (478/810) cases during bronchoscopy. Yield of forcep biopsy & forcep biopsy plus bronchial wash in EEL is 89.25% (723/810) & 93.08
% (754/810) respectively. Yield of EBNA, EBNA plus bronchial wash & EBNA plus forcep biopsy in EEL is 64.56% (523/810), 67.28% (545/810) & 97.65% (791/810) respectively. Total yield of all fiberoptic bronchoscopy  guided procedures (EBNA+FB+BW) in EEL is 100%. Additional yield of EBNA in EEL over other CDTs is 6.92%. Sensitivity of forcep biopsy & EBNA in diagnosing lung malignancy in EEL is 89.25% & 64.56% respectively. Forcep biopsy is more sensitive technique than EBNA in EEL. (p <0.00001). Sensitivity of forcep biopsy plus bronchial wash in EEL is 93.08% (754/810). Sensitivity of EBNA plus bronchial wash in EEL is 67.28% (545/810).Sensitivity of EBNA plus forcep biopsy in EEL is 97.65% (791/810) (p<0.00001)
Conclusion: Endobronchial needle aspiration has documented very crucial role in diagnosing lung cancer in comparison to other conventional diagnostic techniques. Although Forcep biopsy is more sensitive test then EBNA in EEL in diagnosing disease, we have documented EBNA has significant additive yield in proportionate number of cases. EBNA is safe, sensitive and cytology samples can give comparable results to histopathology.


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Patil, S., Acharya, A., & Babhalsure, S. (2023). Diagnostic Role of Bronchoscopy guided Endobronchial Needle Aspiration cytology Exophytic endobronchial lesions: A single-center study in a tertiary care setting in India: Diagnostic Role of Bronchoscopy guided Endobronchial Needle Aspiration cytology. Journal of One Health Research, 1(2), 25–33. https://doi.org/10.5281/zenodo.7887088